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NPI Code Detail

MEDICARE: ANOOP CHACKO

MEDICARE:   ANOOP  CHACKO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist042614NY

General Provider Information

NPI Number : 1154835957
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANOOP CHACKO
Provider Business Mailing Address
First Line : 7324 YELLOWSTONE BLVD
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4137
Country : US
Telephone Number : 718-268-2888
Fax Number : 718-268-2889
Provider Business Practice Location Address
First Line : 3244 31ST ST
Second Line :
City : ASTORIA
State : NY
Zip : 11106-2561
Country : US
Telephone Number : 718-707-6970
Fax Number : 718-707-6977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2017
Last Update Date : 04/29/2019

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Directions to “ ANOOP CHACKO ” Practice Location

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